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Background Women with polycystic ovarian syndrome have a high prevalence of metabolic syndrome and type 2 diabetes mellitus. Blacks and Hispanics have a high morbidity and mortality due to cardiovascular disease and diabetes mellitus in the general population. Since metabolic syndrome is a risk factor for development of type 2 diabetes and cardiovascular disease, understanding any racial and ethnic differences in metabolic syndrome amongst women with polycystic ovarian syndrome is important for prevention strategies. However, data regarding racial/ethnic differences in metabolic phenotype amongst women with polycystic ovary syndrome is inconsistent. Objective To determine if there are racial/ethnic differences in insulin resistance, metabolic syndrome and hyperandrogenemia in women with polycystic ovarian syndrome. Study Design Secondary data analysis of a prospective multicenter, double blind controlled clinical trial, the Pregnancy in Polycystic Ovary Syndrome II study, conducted in 11 academic health centers. Data on 702 women with polycystic ovarian syndrome aged 18-40 years who met modified Rotterdam criteria for the syndrome and wished to conceive were included in the study. Women were grouped into racial/ethnic categories Non-Hispanic Whites, non-Hispanic Blacks and Hispanic. The main outcomes were the prevalence of insulin resistance, metabolic syndrome and hyperandrogenemia in the different racial/ethnic groups. Results BMI (35.1 ± 9.8 vs. 35.7 ± 7.9 vs. 36.4 ± 7.9 kg/m2) and waist circumference (106.5 ± 21.6 vs. 104.9 ± 16.4 vs. 108.7 ± 7.3 cm) did not differ significantly between non-Hispanic White, non-Hispanic Black and Hispanic women. Hispanic women with PCOS had a significantly higher prevalence of hirsutism (93.8 vs. 86.8%), abnormal free androgen index (FAI) (75.8 vs. 56.5%), abnormal homeostasis model assessment (HOMA) (52.3 vs. 38.4%) and hyperglycemia (14.8 vs. 6.5%), as well as lower sex hormone binding globulin compared to non-Hispanic Whites. Non-Hispanic Black women had a significantly lower prevalence of metabolic syndrome (24.5 vs. 42.2%) compared with Hispanic women, and lower serum triglyceride levels compared to both Hispanics and non-Hispanic Whites (85.7 ± 37.3 vs. 130.2 ± 57.0 vs. 120.1 ± 60.5 vs. mg/dL, p<0.01), with a markedly lower prevalence of hypertriglyceridemia (5.1 vs. 28.3 vs. 30.5%, p<0.01) compared to the other two groups. Comment Hispanic women with PCOS have the most severe phenotype, both in terms of hyperandrogenism and metabolic criteria. Non-Hispanic Black women have an overall milder polycystic ovarian syndrome phenotype than Hispanics and in some respects, than Non-Hispanic White women.

NCT00719186 and NCT01044862.

In this pilot study, insulin resistance was the most prominent feature characterising NAFLD complicating PCOS. Total testosterone, FAI, DHEAS and 17-hydroxyprogesterone levels were similar between patients with PCOS and without NAFLD.

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BACKGROUND.Cancer of the corpus uteri occurs more commonly among white women in the U.S., yet survival is poorer for black women. This study examined whether this trend has changed and also examined the relation of age and histologic subtype to differences in stage.METHODS. This retrospective cohort study assessed incidence trends, mortality trends, and the relation of age and histologic subtype to stage for 12,079 incident cases and 2325 deaths registered between 1985 and 1994 in Michigan. Rate ratios compared incidence and mortality. Odds ratios quantified the contribution of age and histologic subtype to differences in risk for advanced stage, using Mantel-Haenszel univariate techniques and multivariate logistic regression. RESULTS.The overall incidence rate was 21.99 per 100,000, and the overall mortality rate was 3.82 per 100,000. Black women had a 40% lower risk (rate ratio [RR] ϭ 0.60) of developing cancer of the corpus uteri but had a 54% greater risk (RR ϭ 1.54) of dying from cancer of the corpus uteri. Black women were at greater risk of being diagnosed with either sarcoma or more aggressive adenocarcinoma. However, after adjustment for age and histologic subtype, black women still had an increased risk for advanced stage disease (2.63, 95% confidence interval ϭ 2.19 -3.16). CONCLUSIONS.The disparity between white and black women persists in incidence and mortality trends for cancer of the corpus uteri. The greater frequency of more aggressive histologic subtypes experienced by black women accounts for only 10% of their excess risk for more advanced stage disease.